Healthcare Provider Details

I. General information

NPI: 1043418486
Provider Name (Legal Business Name): SALLY E LINDSEY COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

VUMC 1215 21ST AVE S MEDICAL CENTER EAST SOUTH TOWER SUITE 3312
NASHVILLE TN
37232-0001
US

IV. Provider business mailing address

1017 MATTHEWS AVE
NASHVILLE TN
37216-2124
US

V. Phone/Fax

Practice location:
  • Phone: 615-343-1207
  • Fax:
Mailing address:
  • Phone: 615-228-0682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: